Client Background Form

I acknowledge that I am responsible for all fees and charges that I incur whilst receiving treatment at MouthWorks. I understand that all fees are payable on the day of consultation.  I have read and agree to the Mouthworks Terms and Conditions and Privacy Policy

I acknowledge that I am responsible for all fees and charges that my child incurs whilst receiving treatment at MouthWorks. I understand that all fees are payable on the day of consultation.  I have read and agree to the Mouthworks Terms and Conditions and Privacy Policy